上海市静安区1999-2008年肺结核患者转归状况调查

Factors associated with outcomes of pulmonary tubel culosis in Jing′an district of Shanghai,1999-2008

目的分析上海市静安区结核病患者的治疗结局,深入了解肺结核患者治疗结局的影响因素。方法调查在静安区1999年1月到2008年12月确诊的901例肺结核患者。采用SPSS 12.0统计软件,进行单因素χ2检验和多因素logistic回归分析,P<0.05为差异有统计学意义。结果肺结核病人的总治愈率为88.3%。单因素分析显示:年龄(<60岁与≥60岁两组)、性别、职业种类、合并症、化疗史、痰涂片、副反应及服药规律、病灶范围大小等9个因素与治疗结果有关(P<0.05)。多因素分析显示:性别、复治、肺部病变灶范围、服药是否规律及合并症是影响治疗结局的主要因素(P<0.05)。结论 (1)服药的规范、复治、合并症、性别及肺部病灶范围是影响肺结核治疗的主要因素。(2)对复治或有合并症或病灶范围累及较大尤其是5个肺野以上的患者采取有针对性的合理治疗方案,加强心理疏导,提高结核治疗及抗结核药服用积极性,规范服药。(3)特别关注提高男性患者治疗的依从性。

Objective To explore factors associated with the outcomes of pulmonary tuberculosis.Methods Six hundred and sixty male and 241 female patients of tuberculosis had been confirmed in Jing′an district of Shanghai between 1999-2008.The epidemiological character istics of disease and data of treatment and outcomes were collected and analyzed with univariate and multivariate logistic regression.Results Seven hundred and ninety-six（88.3%）patients were cured in one year.Univariate analysis showed that variables associated with the efficacy of treatment included sex,age,occupation,retreatment,complication,lung lesions range,compliance to anti-tuberculosis drug treatment,sputum smear testing result and drug side effects.Multivariate analysis confirmed that sex,retreatment,lung lesions range,compliance to anti-tuberculosis drug treatment and complications were significantly associated with outcomes.Conclusion The outcomes of anti-tuberculosis treatment were associated with multiple factors.We should improve the chemotherapy efficacy by necessary re-treatment,decrease and treat the side effect of anti-tuberculosis drugs,and frequently checking the compliance of treatment.